Is It Time for a New Joint?

Millions of us struggle with pain and loss of motion because of joint damage caused by arthritis. If other treatments don’t offer relief, you may wonder about turning in your worn-out joints for new ones.

Surgery may not be your first choice. But if you are a candidate for total joint replacement, know that more than 90% of people have good to excellent results, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. They get relief from pain and can return to normal daily activities.

Should you have surgery?

Joint replacement should be a final step in treatment. More conservative treatments are generally recommended before joint replacement.

Those other treatments include using pain medicine, losing weight to ease stress on the joint, and reducing physical activities that cause pain. Healthcare providers also may suggest exercises to keep muscles and joints flexible, promote fitness, and make muscles stronger that support damaged joints.

While most people undergoing joint replacement surgery are in their 60s or older, younger people may undergo joint replacement when their condition supports this. However, younger people may have other choices available to them like changing to a less physically demanding job, or having a different type of procedure that realigns or only replaces part of a joint.

The younger you are when you get a new joint, the more likely you are to need surgery to revise the joint replacement in the future. Surgery to fix or replace artificial joints has a risk of infection and other complications about 4 times greater than the first surgery. Because healthcare providers shape and remove bone to accept the new joint, repeated surgery also leaves less bone to attach to each new joint.

When do you need surgery?

X-ray evidence of joint damage is 1 of the factors used to decide who should have this surgery. Your pain and other symptoms are the most important things to keep in mind when deciding. This is mostly a quality of life decision.

People who are considered for joint replacement surgery should have 1 of the following: severe pain during activity, such as walking or getting up from a chair; pain that prevents them from doing activities; or pain at night that prevents them from sleeping.

What can you expect?

To get ready, you should work with your healthcare provider to be sure you can tolerate anesthesia. Have dental problems fixed before surgery to reduce the risk for infection. Any medical problems should be made stable before surgery.

Total joint replacement involves a 2-day or 3-day hospital stay. Typical hip and knee patients can walk the next day using a walker. You'll probably be released from the hospital on the third or fourth day, but you'll need time to recover.

At first, you may need items like crutches or a walker after hip replacement. Within a few months, you should be able to return to most of your normal daily activities without help. You may still need physical therapy.

After shoulder replacement surgery, you can start shoulder exercises with someone else moving the joint for you. Three to 6 weeks after surgery, you'll do exercises a therapist gives you. In time, you'll begin to stretch and strengthen your shoulder so you can get back to normal use with far less pain than you had before the surgery.

Recovery from joint replacement surgery generally involves some pain for 2 to 3 months. However, it's usually a different type of pain and will go away as you recover.

Will a new joint last?

Experts warn against unrealistic expectations for a new joint. You shouldn't expect it to bear activities that involve jumping or the kind of stress that would be hard on a natural joint. Your healthcare provider will advise you to avoid certain activities after surgery. Your healthcare provider may even recommend that you should avoid certain joint positions in order to prevent dislocation of the joint. The limitations given will depend on the joint that is replaced, as well as your situation.

An artificial joint will eventually develop changes from wear and tear, even under normal use and activity conditions. It may need to be replaced at some point. Artificial joints generally last 10 to 15 years. A person who is younger at the time of the joint replacement surgery may eventually need to have the new joint replaced. The good news is that new materials being developed for joint replacement are giving artificial joints a longer life span.

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